title: Osteomalacia as inaugural manifestation of Sjögren syndrome.
abstract: Osteomalacia is a relatively common condition, which is frequently underdiagnosed due to lack of clinical suspicion and non-specific symptoms. Osteomalacia can complicate tubulo-interstital nephritis. However, it occurs exceptionally as the first manifestation of Sjögren syndrome with renal involvement. It is a consequence of chronic metabolic acidosis and is associated with distal renal tubular acidosis. We report a 31-year-old woman hospitalised for a 1 year history of muscle weakness and joint and chest wall pains. Skeletal imagery showed Looser's zones in the left femoral neck. Investigations concluded to the diagnosis of primary Sjogren's syndrome.
authors.affiliation: Faculty of Medicine of Tunis, Department of Internal Medicine, Charles Nicolle's Hospital, Tunis El Manar, Tunis, Tunisia.
authors.forename: Eya
authors.initials: E
authors.lastname: Cherif
authors.forename: Lamia
authors.initials: L
authors.lastname: Ben Hassine
authors.forename: Zouleikha
authors.initials: Z
authors.lastname: Kaoueche
authors.forename: Narjess
authors.initials: N
authors.lastname: Khalfallah
mesh_terms: D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D010018:Osteomalacia / Q000175:diagnosis / Q000209:etiology*; D011877:Radionuclide Imaging; D012859:Sjogren's Syndrome / Q000150:complications / Q000175:diagnosis*; D051598:Whole Body Imaging / Q000379:methods